I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. •Store DUPIXENT Syringes in the refrigerator between 36°F to 46°F (2°C to 8°C). How to use Dupixent (dupilumab) syringes: 1) Wash your hands with soap and water before injection. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. This inflammation is an important component in. Please see Important Safety Information and Prescribing Information and Patient Information on website. “It was like something out of a dermatology fairy tale. I need another treatment. æoßÌ Û©¢h— ¶F Ÿ8Or V¤Ú p´Òúh Òkñ ä ± ~> ~àÒ; ‡ Ì l>û Ø ¬¾ÞÐçž$¸ «>÷û²UôÍñù;?x Keep DUPIXENT Syringes and all medicines out of the reach of children. Most do, some don't. Enroll eligible patients in the DUPIXENT MyWay® patient support program for DUPIXENT® (dupilumab) access, financial assistance & nursing support. We'll keep those "Instructions for Use" nearby and then lay the pre-filled syringe on a flat surface and let it naturally warm at a room temperature of less than 77°F (25°C). Serious side effects can occur. I have included a detailed explanation of the severity of [Patient’s First Name]’s disease, informationWith DUPIXENT, and less nasal polyps, you can do more of what matters most. Mine had just exhausted a few months ago after 2 years, and I'm currently paying $70 for 2 shots with Blue Cross Blue Shield. com is a great place to begin your research. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. (20% of ~$3,500) DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Before using DUPIXENT, tell your healthcare provider about all your medical conditions, including if you: have eye problems; have a parasitic (helminth)The most foolproof way to reduce out-of-pocket costs for Dupixent is a free coupon from SingleCare. In children 6 months to less than 12 years of age, DUPIXENT should. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offerEvery enrolled patient is assigned a DUPIXENT MyWay® Nurse Educator who can provide tools, resources, and education throughout the treatment journey. Although you are not eligible, you can sign up DUPIXENT MyWay. I know my Co. Current patient Patient’s first name . Dupixent MyWay pays the $500 copay. Do not try to inject DUPIXENT until you have been shown the right way by your healthcare provider. Count to 5 to be sure you get the full dose. The formulary status tool below can help check DUPIXENT coverage for various plans. DUPIXENT, a biologic, is a type of medication that is processed in the body differently than oral or topical medications. How is Dupixent supplied? Dupixent comes as a single-use pre-filled syringe (with a needle shield) or as a pre-filled pen. Most dermatologists should know about it. *Please enter your. My question is - my next refill for 2024 would be early January. DUPIXENT® is indicated as an add-on maintenance treatment of adult and pediatric patients 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid. In children 12 years of age and older,For more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. Living with my nasal polyps was exhausting. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT (maximum of $13,000 per patient per calendar year) if they meet the eligibility requirements, including: Have commercial insurance, including health insurance exchanges, federal employee plans, or state employee plans. At that point we will owe 20% of the cost of the medication, which adds up to just under $700/month. It has extremely quickly resolved almost all of my eczema. Discover clinical, histologic, and endoscopic results 1-3. The relief is indescribable, honestly. Especially tell your healthcare provider if you. LEARN HOW WE CAN HELP DUPIXENT MyWay. Keep DUPIXENT Syringes and all medicines out of the reach of children. If you are a New York prescriber, please use an original New York State prescription form. Especially tell your healthcare provider if you. Your office may choose to use a preferred specialty pharmacy to start the benefits investigation. Check your eligibility for the DUPIXENT MyWay® Copy Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. Exception: Requests for drugs administered by a healthcare professional that will be billed to the medical plan, call 1-866-752-7021 or fax. DUPIXENT can be used with or without topical corticosteroids. I only felt a pinch, like for the covid vaccine. For additional information or if you have questions, contact your Field Representative or call DUPIXENT MyWay at 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am–9 pm Eastern time. Monday-Friday, 8 am-9 pm ET. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. SCHEDULING. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. In children 12 years of age and older,It was granted and I pay $0. My face/neck which has always. I already know about the Dupixent my way, and programs, trust me when I say, it’s not happening for me, it’s also not only my choice. Monday-Friday, 8 am - 9 pm ET. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,Through the Patient Assistance Program, qualified patients who are uninsured or whose insurance does not cover DUPIXENT could receive DUPIXENT at no cost. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. If you are a New York prescriber, please use an original New York State prescription form. Ask the prescriber for a free sampleDUPIXENT® is a prescription medicine used as an add-on maintenance treatment for uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 6 years and older. In clinical studies utilizing a symptom measurement tool, people taking DUPIXENT saw a meaningful improvement in their nasal polyps symptoms, which included, but were not limited to: • Nasal blockage • Facial pain/pressure • Difficulty falling asleep • FatigueThe recommended dosage of DUPIXENT for adult patients is an initial dose of 600 mg (two 300 mg injections), followed by 300 mg given every other week (Q2W). Serious side effects can occur. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. You need to have a prescription for DUPIXENT as well as commercial insurance. Monday-Friday, 8 am-9 pm ET. ®DUPIXENT (dupilumab) Prescription Information Prescriber Certification: My signature certifies that the person named on this form is my patient; the information provided on this application, to the best of my knowledge, is complete and accurate; that therapy with DUPIXENT is medically necessary; and that I have prescribed DUPIXENT to the CONTRAINDICATION: DUPIXENT is contraindicated in patients with known hypersensitivity to dupilumab or any of its excipients. Pay as little as $0 per month. In order to be effective and work properly, most biologics are injectable medicines. Serious side effects can occur. For more information, dial 1‑844‑DUPIXENT 1-844-387-4936 Monday-Friday, 8 am-9 pm ET. Full Prescribing Information: Patient Information: Learn more about DUPIXENT: Thanks for c. And while everyone’s working through the details, look to DUPIXENT MyWay for additional support. These programs and tips can help make your prescription more affordable. Explore safety data across clinical trials in patients aged 12+ with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma using DUPIXENT® (dupilumab) as add-on maintenance treatment. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. If your healthcare provider decides that you or a caregiver can give DUPIXENT injections, you or your caregiver should receive training on the right way to prepare and inject DUPIXENT. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. Step One - let's gather our materials. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. My name is Shari and I’m a registered nurse with DUPIXENT MyWay. Prurigo Nodularis: The most common adverse reactions (incidence ≥2%) are nasopharyngitis, conjunctivitis, herpes infection, dizziness, myalgia, and diarrhea. DUPIXENT is a prescription medicine used to treat adults and children 6 months of age and older with moderate-to-severe eczema (atopic dermatitis or AD) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. You likely have a specialty Pharmacy but just aren't aware of it since you're new to the Dupixent scene. difficulty in breathing. For more information, dial 1-844-DUPIXENT1-844-387-4936), option 1. I also enrolled in the dupixent my way program and my ambassador told me that as long as you don’t make $100,000 a year you qualify for the program to get dupixent free for a year. loss of voice. my eligibility for the DUPIXENT MyWay Patient Assistance Program, and I understand that such verification may include contacting me or my healthcare provider for additional information and/or reviewing additional financial, insurance, and/or medical information. Surgery may remove your nasal polyps, but it may not treat an underlying cause of inflammation—allowing them to grow back. Serious side effects can occur. insurer. DUPIXENT works by targeting an underlying source of inflammation that could be a root cause of your eczema. Dupixent works. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. Based on the questions answered above, you are not eligible to register for a new copay card or to activate a copay card. Learn more about DUPIXENT® (dupilumab), is the first FDA-approved biologic to treat eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg). Sorry you interpreted my post that way. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. Monday-Friday, 8 am-9 pm ET. About Dupixent. One of my favorite parts of providing nursing care to our patients is being able to walk them through their journey, hold their hand through the process, just to give them confidence along the way and we always want them to know that they. It's hard enough dealing with all of this and having different doctors tell you different things is mind boggling. Learn how to inject DUPIXENT® (dupilumab), a biologic subcutaneous injectable prescription medicine for eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg). The formulary status tool below can help check DUPIXENT coverage for various plans. Watch videos from experts [,download materials,] and explore future events to further understand DUPIXENT® (dupilumab). Dupilumab también se usa junto con otros medicamentos para tratar el asma de moderado a severo que no se. 98% of Commercially Insured Patients. If your healthcare provider decides that you or a caregiver can give DUPIXENT injections, you or your caregiver should receive training on the right way to prepare and inject DUPIXENT. Complete the entire form and submit pages 1-2 to DUPIXENT MyWay® via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8. I chose to be a nurse because I wanted to help people, and I believe that people should be in service to others. Clinical, histologic, and. It was "free" my first 2 years with my insurance hitting me with a $1,000 / month copay but the dupixent my way program gives you $13,000 a year copay assistance so $0 3rd year my insurance changed and it was $3300 a month copay so that sucked the dupixent my way help dry by March so I have been without most of 2022. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. Your email is on its way. insurer. If you are a New York prescriber, please use an original New York State prescription form. To get started: Contact your DUPIXENT MyWay Support Team for an C M ET DUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370) PRESCRIBER TO FILL OUT Section 6a. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. DUPIXENT can be used with or without topical corticosteroids. Want to be a part of the DUPIXENT MyWay® Ambassador Program? Fill out this self-nomination form to see if you qualify. You will find 3 options; typing, drawing, or uploading one. Learn more about DUPIXENT® (dupilumab), is the first FDA-approved biologic to treat eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg). Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. It may be covered by your Medicare or insurance plan. ago. Start Program product to the patient named herein. In children 12 years of age and older,Hello! The Medisafe Web Portal doesn’t work on small screens (yet). If you are a New York prescriber, please use an original New York State prescription form. 73K likes, 905 comments - krisaquino on November. (DUPIXENT + Topical Corticosteroids (TCS) vs TCS only): CLEAR OR ALMOST CLEAR SKIN AT 16 Weeks 39% taking DUPIXENT + TCS vs 12% using TCS only. Normally my copay would be about $970 per refill, but with about 12 refills per year this does not max out the Dupixent MyWay copay card. Dupixent Interactions. Please see Important Safety Information and Prescribing. best of luck!! i hope you can get on dupixent soon. Good luck to all! I still have it on legs and arms but it's nothing compared to full body day and night. Terms & Restrictions Apply. To get patient-specific information about coverage for a drug, phone Health Insurance BC. To request access to someone else's record in MyHealth complete the Request Access to Someone Else’s Account form . Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. 05. Despite all of the freedom this miracle drug has graciously granted me, I purposely and consciously chose to begin tapering off Dupixent in May of 2017. ®DUPIXENT (dupilumab) Prescription Information Prescriber Certification: My signature certifies that the person named on this form is my patient; the information provided on this application, to the best of my knowledge, is complete and accurate; that therapy with DUPIXENT is medically necessary; and that I. I think it is a true wonder drug and I am grateful for it. insurer. Learn how DUPIXENT® (dupilumab), the first FDA-approved weekly injectable biologic treatment for eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg) targets a source of inflammation, which contributes to EoE. Save. For any questions or concerns, please contact us at the phone number located on your enrollment form. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. DUPIXENT® (dupilumab) is a prescription medicine used to treat people aged 6 years and older with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. I agree to assist in e Éorts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Dupixent® (dupilumab) Note: Precertification review for this medication is handled by Aetna Pharmacy Management Precertification at 1-855-240-0535 or fax applicable request forms to 1-877-269-9916. DUPIXENT® is indicated as an add-on maintenance treatment of adult and pediatric patients 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma. Dupixent MyWay Copay Card Rebate. Select a tab below to get you to helpful information depending on where you are in your treatment journey. DUPIXENT is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. 01. 03. Dupixent is a miracle. This is very helpful!Dupixent MyWay Program Dupixent (dupilumab injection) CONTACT INFODupixent is an injection that is usually given under the skin every other week for the treatment of asthma, eczema, and some other inflammatory conditions. Based on the questions answered above, you are not eligible to register for a new copay card or to activate a copay card. Watch videos for a supplemental demonstration on how to use and dispose of DUPIXENT® (dupilumab), a prescription medicine for subcutaneous injection. Check the liquid in the prefilled pen or syringe. 04. DUPIXENT® (dupilumab) is a prescription medicine used to treat people aged 6 years and older with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. Inflammation of your blood vessels. With our help, you could get your Dupixent prescription for a flat fee of $49 per month. You can be eligible for and DUPIXENT MyWay Copay Card if you:. Be sure to check your inbox. You may be able to lower your total cost by filling a greater quantity at one time. 5. Dupixent. n¬©® &í]ÃÎê)«ÀI¯´[5ì×âÛä#« §„ñ ¶…Ä. If you’re eligible, you can enroll online or by phone and receive your card by email. Please see Important Safety Information and. SIGN UP TO SPEAK WITH A DUPIXENT MyWay ® MENTOR . For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. MELINDA: Before I started DUPIXENT, I told my doctor about all the medical conditions I had and medications I was taking. Find DUPIXENT® (dupilumab) injection videos and instructions for the pre-filled pen (200 mg or 300 mg) for ages 2+ years. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. I authorize the Alliance to use my Social Security number and/or additional. I feel so lucky I have one of the best insurance companies at the moment. Dupixent hit $2. In fact, I mentioned that I agree drugs should be used as an aid and catalyst to one's healing, but not something to be dependent on for the rest of one's life. If you are a New York prescriber, please use an original New York State prescription form. I, _____, certify that the information provided for this reimbursement request is accurate to the best of my knowledge, and. DUPIXENT blocks the signaling of two key sources of Type 2 inflammation (IL-4 and IL-13). Dupilumab. Enrollment Form FOR DERMATOLOGISTS Complete the entire form and submit pages 1-2 to DUPIXENT MyWay® via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am–9 pm ET Patient Name DOB Prescriber. • 300 mg every 4 weeks. Although you are not eligible, you can sign up. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,Full Prescribing Information: Patient Information: Learn more about DUPIXENT: Thanks for c. Each time you fill your DUPIXENT prescription, please ensure your. PRESCRIBER TO FILL OUT Complete the entire form and submit pages 1-2 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) 1‑844‑DUPIXENT 1-844-387-4936. The cost of the 300-milligrams per 2-milliliters (mg/mL) shot of Dupixent will vary based on several factors. Eligible patients will receive their cards by email. Indication. Rotate the injection site with each injection. The upper arm can also be used if a caregiver administers the injection. The DUPIXENT MyWay nurse connects patients to a variety of considerate resources, including one-on-one nursing product, financial assistance for right patients, and helpful refill and injection reminders. ca,. Eligible commercially insured patients may submit a rebate if they paid in full for their prescription at the pharmacy or their prescription was filled before they enrolled in the program; visit to begin the rebate process; for additional information contact the program at 844-387-4936. DUPIXENT® (dupilumab) is indicated as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP). Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. This information will ONLY be used to validate your eligibility. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). It’s a biologic drug, which means it’s made from parts of living organisms. VO: DUPIXENT is a prescription medicine used: to treat people aged 6 years and older with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. Sign up to connect with a DUPIXENT MyWay® mentor to help patients with Nasal Polyps through their DUPIXENT® (dupilumab) treatment journey. This copay card may be for you if you. DUPIXENT is a prescription medicine used to treat certain skin conditions, asthma, and chronic rhinosinusitis with nasal polyps. Serious side effects can occur. I go to college, and already had to extend my time due to eczema and TSW. (2) Financial support for eligible patients: Get information about potential. Registered nurses are also available to speak with eligible patients about DUPIXENT. Get emergency medical help if you have signs of an allergic reaction to Dupixent: hives, rash, itching; fever, swollen glands, joint pain; feeling light-headed, difficult breathing; swelling of your face, lips, tongue, or throat. chevron_right. I really enjoy the patient interaction. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. DUPIXENT MyWay® is a program that helps eligible patients start and stay on track with their therapy for atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyposis,. <br> <br> Best, <br> Ashley</p> reactions . Within 24 hours, one of our patient advocates will call you for a brief interview. I honestly started to taper off Dupixent because I wanted to see how well my body would do without it. DUPIXENT® is a prescription medicine used as an add-on maintenance treatment for uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 6 years and older. DUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. If this is the case, write the preferred specialty pharmacy name and then check the box indicating that you have sent the prescription to the specialty pharmacy, which will. Serious adverse. Being a nurse for DUPIXENT MyWay is very rewarding. Please see. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. Some Medicare plans may help cover the cost of mail-order drugs. DUPIXENT is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. Fill a 90-Day Supply to Save. FDA approves Dupixent ® (dupilumab) as first treatment for adults and children aged 12 and older with eosinophilic esophagitis. About Dupixent Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. The help you get from a copay card is provided by theBUT, the Dupixent MyWay card paid the $600 for me. yes! i am currently using both my insurance and dupixent my way. In children 12 years of age and older, it. Step 4: Hold the syringe at a 45-degree angle. Good luck. Leaving me with $12,400 left on the card. It is not an immunosuppressant or a steroid. Have commercial insurance, including health insurance. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,Pharmaceuticals, Inc. patients cover the out-of-pocket cost of DUPIXENT. Add the date to the sample using the Date feature. How do my patients enroll in <em>DUPIXENT MyWay®</em>? When filling out the DUPIXENT MyWay Enrollment Form, both you and your patient will be required to. 7 out of 10 from a total of 188 reviews for the treatment of Eczema. DUPIXENT, a biologic, is a type of medication that is processed in the body differently than oral or topical medications. In patients aged 18 years and older with prurigo nodularis, Dupixent 300 mg is administered with a pre-filled syringe or pre-filled pen every two weeks following an initial loading dose. Available in two delivery options, pre-filled syringe & pre-filled pen (300mg) for ages 12+ years. DUPIXENT is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. In clinical trials, the impact of DUPIXENT on lung function was studied in patients 6 to 11 years of age and patients 12 years of age and older. Dupixent also isn’t financially in the cards for me. Patient Rebate Portal. Dupixent may cause serious side effects. After that, we will have met our family deductible. Tell your healthcare provider about any new or worsening joint symptoms. How possessed an annual upper of $13,000. DUPIXENT is a biologic and can help reduce your patients' use of systemic corticosteroids. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. Step 2: After washing your hands, clean the area you are going to inject with an alcohol wipe. Dupixent Side Effects (Took my first 2 shots about 2 weeks ago) Hello all. There is currently no generic alternative to Dupixent. These programs and tips can help make your prescription more affordable. Review patient eligibility for the DUPIXENT MyWay® Copay Card for DUPIXENT® (dupilumab) and explore patient assistance programs for eligible patients. The phone number is 1‑844‑DUPIXEN (T) (1-844-387-4936) Option 1, Monday–Friday, 8 AM–9 PM Eastern time. Dupilumab se usa para el eczema en adultos y niños de 6 meses o más. 1 A patient may self-inject DUPIXENT—or a caregiver may administer DUPIXENT—after training has been provided by a healthcare provider on proper subcutaneous injection technique using the pre-filled syringe or pre-filled pen 2 Patient Assistance Connection Financial Eligibility(for uninsured or functionally uninsured patients) Determine the maximum household income requirement to be considered for Patient Assistance Connection by selecting your household size and then viewing the 400% column. Patient Assistance Connection Financial Eligibility(for uninsured or functionally uninsured patients) Determine the maximum household income requirement to be considered for Patient Assistance Connection by selecting your household size and then viewing the 400% column. 3) Push the plunger down slowly until the syringe is emptied. Welcome to the Patient Support Portal! This site provides patients and healthcare professionals a fast secure way to submit the patient enrollment and supporting. DUPIXENT MyWay® is a patient support program designed to help you get access to DUPIXENT and help eligible patients cover the out-of-pocket costs of DUPIXENT. Program has an annual maximum of $13,000. For children weighing 30 kg or more, the dosage is 200. In clinical trials, DUPIXENT reduced the. Self-nominate to become DUPIXENT MyWay® Ambassador, and if selected, you may have opportunities to share your story and offer encouragement to patients and their family members. , One-on-One Nurse Education, and Supplemental Injection Training) Please click “Continue. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. More common side effects in people taking Dupixent for asthma include: reactions where the drug is injected, such as pain and swelling. Press and hold the Dupixent Pre-filled Pen firmly against your skin until you cannot see the yellow needle cover. com. The appeal process Example letters. If you are a New York prescriber, please use an original New York State prescription form. DUPIXENT® is a prescription medicine used as an add-on maintenance treatment for uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 6 years and older. DATA UP TO 52 WEEKS is available. But either way, after you or Dupixent myway meets your deductible, it should be free to you. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. You should call your doctor or your insurance company and ask for the specialty pharmacy information. DUPIXENT blocks the signaling of two key sources of Type 2 inflammation (IL-4 and IL-13). Stop using DUPIXENT ®. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. I have tried everything you can think of, to manage my nasal polyps. swelling of the face, lips, mouth, tongue, or throat. "37, male, Asian, suffered from Atopic Dermatitis for 20 yrs. THE DUPIXENT MyWay COPAY CARD. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. If you are a New York prescriber, please use an original New York State prescription form. pretty obvious to both my pharmacist and MyWay nurses that simply running through the $13,000 in a few months is not the way the copay assistance is intended to be used, but. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. My name is Shari and I’m a registered nurse with DUPIXENT MyWay. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. Education and Nurse Support: One-on-one nursing support is available to educate and empower patients to use DUPIXENT as prescribed. with DUPIXENT Help schedule deliveries of DUPIXENT Provide supplemental injection training—in person, virtually, or over the phone—to help patients or caregivers become more familiar with injecting DUPIXENT Offer a needle disposing kit, or sharps container, for proper disposal of DUPIXENT Remind patients when it is time toMy doctor gave me a copay card to cover mine. O. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. View all Regeneron Pharmaceuticals Inc. xml ¢³ ( ¼–ËnÛ0 E÷ ú ·…E' Š¢°œE Ë6@] [š ÙDù 9Nâ¿ïPŠÙÄq¬$Žº ‘sï!çaÏ. x DUPIXENT Syringes can be stored at room temperature up to 77°F (25°C) up to 14 days. PRESCRIBER TO FILL OUT Section 5a. 26 [95% CI: 0. DUPIXENT can be used with or without topical corticosteroids. DUPIXENT ® ️ can cause allergic reactions that can sometimes be severe. This document provides detailed instructions for using the DUPIXENT Pre-filled Syringe with a 300 mg dose. I certify that I have obtained my patient’s written authorization in accordance with applicable Patients may be eligible for the DUPIXENT MyWay® copay card if they: Have commercial insurance; Have a DUPIXENT prescription for an FDA-approved condition; Are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI; and are a patient or caregiver aged 18 years or older For patients wanting a copay card, they can access that by visiting our product website at DUPIXENT. Please see Important Safety Information and Patient Information on. If your office does not use a preferred specialty pharmacy, leave the box unchecked to indicate that you would like DUPIXENT MyWay to conduct the benefits investigation on the patient’s behalf. medisafe. *Please enter your patient. financial assistance for eligible patients, provide one-on-one nursing support, and more. Fill a 90-Day Supply to Save. Tips. I, _____, certify that the information provided for this reimbursement request is accurate to the best of my knowledge, and the product-specific copay, DUPIXENT MyWay is a patient support program designed to help you get access to DUPIXENT and stay on track while providing helpful tools and resources. DUPIXENT MyWay®. Fax: 1-908-809-6249. DUPIXENT® (dupilumab)'s patient education program events let you meet other adults living with moderate-to-severe eczema (atopic dermatitis) or caregivers of a patient living with moderate-to-severe eczema (atopic dermatitis). Self-nominate to become DUPIXENT MyWay® Ambassador, and if selected, you may have opportunities to share your story and offer encouragement to patients and their family members. Serious adverse reactions may occur. 2020;157 (4):790-804. She looked at my broke out skin and said I could definitely benefit from Dupixent, especially. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,DUPIXENT® (dupilumab) is the first and only FDA-approved treatment for eosinophilic esophagitis (EoE), indicated for adult & pediatric patients aged 12+ years, weighing at least 40 kg. DUPIXENT MyWay Nurse Educators are trained to help provide patients with supplemental injection training either online, over the phone, or in person with a training kit and. The most common side effects may include injection site reactions, pink eye, eyelid inflammation, cold sores, and mouth or throat. I authorize the Alliance to use my Social Security number and/or additional. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as a $0* copay per fill of DUPIXENT, maximum of $13,000 per patient per calendar year. And, if you're eligible, you can sign up and receive your card today. My allergist doctor said I was a super reactive patient to Dupixent, in a positive way. Brovana - Save up to $30 per month. Please see Important Safety Information and Patient Information on website. If you are a New York prescriber, please use an original New York State prescription form. (See “Children’s dosage” below for. headache. insurer. com. CHRONOS was a 52-week pivotal clinical trial evaluating the efficacy and safety of DUPIXENT in adult patients with uncontrolled moderate-to-severe atopic dermatitis. 1 Disease severity was defined by an IGA score ≥3 in the overall assessment of atopic dermatitis. For more information, call 1. The dupixent my way enrollment form isn’t an exception. Have commercial services, including health insurance markets,. 2 pens of 300mg/2ml. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. In adults and children 6 years and older, your initial dose of DUPIXENT is 2 injections under the skin (subcutaneous injection) at different injection sites. Tell your healthcare provider about any new or worsening joint symptoms. Daliresp - Pay as little as $25. I’m ready to make a difference. TRANSFORM THE WAY YOU MANAGE EoE. Start Program product to the patient named herein. I pay nothing. Welcome to the Patient Support Portal! This site provides patients and healthcare professionals a fast secure way to submit the patient enrollment and supporting documentation to our patient services program team. I'm supposed to start myself at some point, I guess with the pen though I know there's a choice. Both through prescribing physicians, but dupixent's gone pro-active and implemented the my way reporting line for patients to self report adverse events as well. For children weighing 15 kilograms (kg)* to less than 30 kg, the dosage is either: • 100 mg every other week, or. Come back and visit us using a device with a larger screen (laptop, desktop, tablet) at web. Does that mean I'd be at ($9000-3,400. 5K subscribers. They are especially crucial when it comes to stipulations and signatures associated with them. . Eye pain, redness, irritation, or discharge with blurry or decreased vision. Dupixent will run about $3000 per month with my insurance until my maximum is met. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. This will allow the specialty pharmacy to conduct the benefits investigation, and DUPIXENT MyWay will provide additional support to the patient.